A doctor who works in a remote northern Ontario First Nation told a parliamentary committee Thursday that aboriginal people on remote reserves like Attawapiskat receive “far inferior” health care and urged “drastic change.”

Dr. Mike Kerlew, who works in the fly-in community of Wapakeka First Nation, told the Standing Committee on Aboriginal Affairs and Northern Development that the standard of care on reserves is “not just a little inferior -- far inferior.”

The physician said a common problem is medication shortages. He asked committee members to imagine a situation where “a young person comes into the clinic and their (broken) leg is on a virtual right angle (and) you do not have adequate supplies of the pain medication that they need, and it takes nine-and-a-half hours for that medevac to come in.”

“That entire time, because that supply of morphine is not there in sufficient quantities, you hear that person screaming,” he said. “That is the reality.” He could not say why the medication shortages occur.

Dr. Kirlew said his pregnant patients’ number one fear is that they will be forced to deliver babies alone, because the federal government won’t pay for a friend or loved one to travel with them to a hospital hundreds of kilometres off-reserve.

“I think the practice of denying pregnant women escorts needs to stop immediately,” he said. “Which one of us would want to deliver our child without our partner there?”

Dr. Kirlew said he is unable to provide his patients with mental health care, speech language therapy and autism therapy because it is not available in the community and the government sometimes refuses to pay for travel to places where such services are available.

“I have children with Autism Spectrum Disorder with zero access to service,” he said.

Dr. Kirlew said the system for approving spending, known as the Non-Insured Health Benefits Program, is antagonistic and that doctors feel policed. “Why does non-insured health benefits need to know why a person is getting an MRI?” he said.

“There needs to be drastic change, quickly,” he added. “The longer we wait, the more people will die.”

First Nations leaders who spoke at the committee meeting emphasized that they do not believe budgets are sufficient to deal with the unique needs of the north, where health care delivery is particularly expensive.

Ontario Regional Chief Isadore Day said that the remote north has “very specific needs.”

“You can no longer do business like this in terms of health,” he said. “It cannot be based on budget limits; it has to be based on the needs within the region.”

Conservative MP David Yurdiga asked whether the First Nations leaders believe that the $8.4 billion over five years promised by the Liberals have promised to improve life for indigenous people is sufficient to address health crises, like the recent spate of suicide attempts in Attawapiskat.

Johnathan Solomon, Grand Chief of the Mushkegowuk Council that represents Attawapiskat, said he agrees with Chief Day that “the logistics or the remoteness factor” must be taken into account when budgeting.

“It’s trying to fit everything for Ottawa or Toronto and it doesn’t work,” he said.

Liberal MP Michael McLeod, who is Métis, said he sees “two ways to approach” the crises.

“We can continue to subsidize the communities, try to put social programs in,” he said. “Or we can build pride in our people by providing them work, developing skills, creating opportunity for them so they can build their own houses, so they can do a lot of things on their own.”

“We have good people in our communities, we have smart people in our communities who want to work (but) we’re lacking infrastructure so why don’t we try and approach it from that front?” McLeod asked.

Chief Day responded forcefully that Attawapiskat has a diamond mine “right there,” but that the First Nation has received only a “pittance” because it does not have “first right of refusal” to development in their territory.

“If they had access to the wealth and resources from that mine, do you think they would be in the condition they are in now?” he said. “No, they would have schools, they would have roads, they would have everything they need to be happy and healthy.”

The Attawapiskat First Nation signed an agreement in 2005 with the mining company De Beers, which describes the benefits the community would receive, including training programs, employment and annual payments into a trust fund for the community.

As of 2011, the trust fund had received more than $10 million. By 2013, 41 per cent of the mine’s roughly 500 employees were Aboriginal, including about 100 from Attawapiskat, according to De Beers.

Attawapiskat's leaders declared a state of emergency last week after 28 recorded suicide attempts in March. On Monday, officials said thwarted a suicide pact by 13 young people in the community